Radiographic measurement of prevertebral soft tissue thickness on lateral radiographs of the neck

Object Anterior cervical plating decreases the risk of pseudarthrosis following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-profile, stand-alone polyetheretherketone (PEEK) interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited. The object of the present study was to determine the clinical and radiological outcomes for patients who underwent ACDF using a zero-profile integrated plate and spacer device, with a focus on the course of postoperative prevertebral soft-tissue thickness and the incidence of dysphagia. Methods Using a surgical database, the authors conducted a retrospective analysis of all patients who had undergone ACDF between August 2008 and October 2011. All patients received a Zero-P implant (DePuy Synthes Spine). The Neck Disability Index (NDI) and visual analog scale (VAS) scores for arm and neck pain were documented. Dysphagia was determined using the Bazaz criteria. Prevertebral soft-tissue thickness, spinal alignment, and subsidence were assessed as well. Results Twenty-two male and 19 female consecutive patients, with a mean age of 58.4 ± 14.68, underwent ACDF (66 total operated levels) in the defined study period. The mean clinical follow-up in 36 patients was 18.6 ± 9.93 months. Radiological outcome in 37 patients was assessed at a mean follow-up of 9.76 months (range 7.2–19.7 months). There were significant improvements in neck and arm VAS scores and the NDI following surgery. The neck VAS score improved from a median of 6 (range 0–10) to 0 (range 0–8; p < 0.001). The arm VAS score improved from a median of 2 (range 0–10) to 0 (range 0–7; p = 0.006). Immediate postoperative dysphagia was experienced by 58.4% of all patients. Complete resolution was demonstrated in 87.8% of affected patients at the latest follow-up. The overall median Bazaz score decreased from 1 (range 0–3) immediately postoperatively to 0 (range 0–2; p < 0.001) at the latest follow-up. Prevertebral soft-tissue thickness significantly decreased across all levels from a mean of 15.8 ± 4.38 mm to 10.1 ± 2.93 mm. Postoperative lordosis was maintained at the latest follow-up. Mean subsidence from the immediate postoperative to the latest follow-up was 4.1 ± 4.7 mm (p < 0.001). Radiographic fusion was achieved in 92.6% of implants. No correlation was found between prevertebral soft-tissue thickness and Bazaz dysphagia score. Conclusions A zero-profile integrated plate and spacer device for ACDF surgery produces clinical and radiological outcomes that are comparable to those for nonintegrated plate and spacer constructs. Chronic dysphagia rates are comparable to or better than those for previously published case series.

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Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement

Journal of Bone and Joint Infection ◽

10.5194/jbji-6-211-2021 ◽

2021 ◽

Vol 6 (6) ◽

pp. 211-217

Author(s):

Laura Rey Fernández ◽

Francesc Angles Crespo ◽

Silvia María Miguela Álvarez ◽

Martí Carles Bernaus-Johnson ◽

Agustí Bartra Ylla ◽

...

Keyword(s):

Soft Tissue ◽

Total Hip Replacement ◽

Hip Replacement ◽

Joint Infection ◽

Radiographic Measurement ◽

Tissue Thickness ◽

Total Hip ◽

Replacement Surgery ◽

Hip Replacement Surgery ◽

Soft Tissue Thickness

Abstract. The objective of our study was to evaluate the association between acute periprosthetic joint infection (APJI) and radiographic measurement of soft-tissue thickness in elective total hip replacement surgery. A case-control study was conducted to compare the soft-tissue thickness radiographic measurement (SRM) at the hip in patients diagnosed with APJI based on Tsukayama et al. (2003) criteria after total hip replacement with patients that were not infected, at a single institution from 2013 to 2019. To minimize selection bias, each case was matched with two controls using the following methodology: patients of the same sex, with an age variation of ± 5 years, and nearest in surgery date to the cases were selected. All postoperative radiographs were performed in the first 24 h after total hip arthroplasty (THA) surgery as it is protocolized in our institution. Soft-tissue thickness radiographic measurement was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in postoperative anteroposterior hip radiographs. In total, 78 patients were included (26 cases and 52 controls). The SRM median of the cases was 76.19 mm (SD: 26.518) and 53.5 mm (SD: 20.47) in controls. A multivariate logistic regression model showed an independent association between APJI and SRM (odds ratio (OR) = 1.033, 95 % confidence interval (CI) 1.007–1.059, p=0.012). Patients with an SRM greater than 60 mm had a 7-fold increase in the odds of APJI (OR = 7.295, 95 % CI = 2.364–22.511, p<0.001). The results of our study suggest an association between large SRM at the hip and the risk of APJI in patients with primary total hip arthroplasty. SRM may be a helpful and easy tool for evaluating the risk of APJI before elective primary total hip replacement surgery.

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Normal Pediatric Prevertebral Soft-Tissue Thickness on MDCT

American Journal of Roentgenology ◽

10.2214/ajr.10.6288 ◽

2012 ◽

Vol 199 (1) ◽

pp. W130-W133 ◽

Cited By ~ 10

Author(s):

David Vermess ◽

Carlos A. Rojas ◽

Fawad Shaheen ◽

Pinakpani Roy ◽

Carlos R. Martinez

Keyword(s):

Soft Tissue ◽

Tissue Thickness ◽

Soft Tissue Thickness ◽

Prevertebral Soft Tissue

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A CLOSER LOOK TO PREVERTEBRAL SOFT TISSUE THICKNESS ON MAGNETIC RESONANCE IMAGES

10.21506/j.ponte.2016.8.26 ◽

2016 ◽

Vol 72 (8) ◽

Author(s):

Hatice Gul Hatipoglu ◽

Hatice Nursun Ozcan ◽

Ergun Daglioglu ◽

Bulent Sakman

Keyword(s):

Magnetic Resonance ◽

Soft Tissue ◽

Magnetic Resonance Images ◽

Tissue Thickness ◽

Soft Tissue Thickness ◽

Prevertebral Soft Tissue

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Prevertebral Soft Tissue Thickness among Pediatric Patients

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v26i2.565 ◽

2011 ◽

Vol 26 (2) ◽

pp. 5-9

Author(s):

Manuelito M. Reyes ◽

Rosario R. Ricalde ◽

Jennifer B. Tanalgo ◽

Concepcion J. Baldoz

Keyword(s):

Soft Tissue ◽

Pediatric Patients ◽

Cervical Vertebra ◽

Neck Surgery ◽

Government Hospital ◽

Inclusion Criteria ◽

Tissue Thickness ◽

Soft Tissue Thickness ◽

Prevertebral Soft Tissue ◽

Cervical Vertebral Body

Objective: This study aimed to determine the prevertebral soft tissue thickness among normal patients aged 0-14 years old in a tertiary government training hospital, to compare these values with divergent criteria in the standard otorhinolaryngology and radiology texts used in our institution, and to recommend adoption of a set of criteria based on the results. Methods Study Design: Descriptive Study Setting: Tertiary Government Hospital Subjects and Methods: Lateral cervical radiographs taken from May 2007 to August 2009 which were initially read as normal were collected. Fifty (50) patients, 39 males and 11 females, aged 0-14 years old meeting inclusion criteria were reviewed and prevertebral soft tissue thicknesses (PVST) and cervical vertebral body diameter at levels C2, C5, C6 were measured and compared to criteria set by standard otorhinolaryngology and radiology textbooks. Results: The average PVST at C2 ranged from 4.02 mm for 2–3 year-olds (n= 2) to 8.16 mm for 1 –2 year-olds (n=2). The average PVST at C5 ranged from 8.11mm for 1–2 year-olds to 10.75 mm for for 0-1 year-olds. The average PVST at C6 ranged from 7.13 mm for 1 – 2 year-olds to 10.36 mm for 0-1 year-olds. Only 12% of the patients satisfied the criteria set by Keats and Lusted, while 100% satisfied Duncan’s criteria, 94% and 98% satisfied Wippold’s 1st and 2nd criteria respectively. Conclusion: All of the PVST criteria mentioned in Cummings’ Textbook of Otorhinolaryngology Head and Neck Surgery had a more than 90% accuracy compared to only 12% for those mentioned in Keats and Lusted’s Atlas of Roentgenographic Measurement. Therefore, we recommend the use of any criteria for PVST contained in the former over the latter. Keywords: Prevertebral soft tissue thickness, cervical vertebra

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ZERO-PROFILE ANCHORED SPACER SYSTEM IN THE TREATMENT OF CERVICAL DEGENERATIVE DISEASE WITH A FOLLOW-UP OF 1 YEAROUR EXPERIENCE .

10.36106/0502460 ◽

2021 ◽

pp. 64-67

Author(s):

Harish chandra Gupta ◽

Alok Nath ◽

Subhasis Ghosh ◽

Sudipto Chatterjee ◽

Shubhamitra Chaudhuri

Keyword(s):

Soft Tissue ◽

Intervertebral Disc ◽

Degenerative Diseases ◽

Tissue Thickness ◽

Postoperative Dysphagia ◽

Soft Tissue Thickness ◽

Intervertebral Disc Height ◽

Prevertebral Soft Tissue ◽

Vas Scores

Objects: Anterior cervical plating decreases the risk of pseudarthrosis, increases rate of fusion following anterior cervical discectomy and fusion (ACDF). Dysphagia is a common complication of ACDF, with the anterior plate implicated as a potential contributor. A zero-prole, stand-alone interbody spacer has been postulated to minimize soft-tissue irritation and postoperative dysphagia, but studies are limited. We are reporting our ndings in term of clinico-radiological outcomes following the use of such devices in the treatment of cervical spine degenerative diseases with a focus on the course of postoperative prevertebral soft-tissue thickness and the incidence of dysphagia. The authors conducted a prospective analysis of all Methods: patients who had undergone ACDF between December 2018 and December 2019. All patients received a Zero-P implant (DePuy Synthes Spine).The Neck Disability Index (NDI),Modied Japanese Orthopaedic Association Score(mJOA) and visual analog scale (VAS) scores for arm and neck pain were documented. Dysphagia was determined using the Bazaz criteria. Prevertebral soft-tissue thickness, spinal alignment, intervertebral disc height were assessed as well. The nal outcome was assessed with Odom's criteria. Total 30 patients Results: were studied prospectively, and data were collected and analyzed. 17 male and 13 female consecutive patients, with a mean age of 48.28 ± 8.17 years, underwent ACDF with Zero-Prole spacer (42 total operated levels) in the dened study period. There were signicant improvements in neck and arm VAS scores, the NDI and mJOA scores following surgery at last follow up. The neck VAS score improved from a mean 7.34 ±1.87 to 1.04 ± 0.09 (p<0.01) . The arm VAS score improved from 7.22±2.03 to1.03±0.10 at latest follow up. NDI score improved signicantly from preoperative 31.94±6.73 to 12.87±5.24 and mJOAscore improved from preoperative 9.53±1.98 to 15.6±1.26 at last follow up. Immediate postoperative dysphagia was experienced by 36.67% of all patients. Complete resolution of dysphagia was demonstrated at the latest follow-up. Prevertebral soft-tissue thickness at postoperative 48 hrs decreased across all levels from a mean of 15.87 ±0.69 to 11.81 ± 0.53 mm at last follow up. Cervical alignment and intervertebral disc height were also improved signicantly after surgery. Radiographic fusion was achieved in 100% of implants. No correlation was found between prevertebral soft-tissue thickness and Bazaz dysphagia score. Majority of the patients had excellent outcomes in odom's criteria. Conclusions: Zero-Prole device is a safe and effective alternative for the treatment of cervical degenerative diseases. Chronic dysphagia rates are comparable to or better than those for previously published case series.

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